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Synthesis of Patterned Media by Self-Assembly of Magnetic http://wjst.wu.ac.th Health Sciences Effects of Three-Dimension Schroth Exercises and Kinesio Taping on General Mobility of Vertebrae, Angle of Trunk Rotation, Muscle Strength and Endurance of Trunk, and Inspiratory and Expiratory Muscle Strength in Children with Idiopathic Scoliosis Roongtip DUANGKEAW1,*, Teerapat LADDAWONG1, Numchai RATTANAPONGBUNDIT2 and Burawan POLMANG3 1Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand 2Division of Sports Medicine, Department of Sports Science, Sports Authority of Thailand, Bangkok 10240, Thailand 3Division of Sports Research and Development, Department of Sports Science, Sports Authority of Thailand, Bangkok 10240, Thailand (*Corresponding author’s e-mail: [email protected]) Received: 21 July 2017, Revised: 21 December 2018, Accepted: 21 January 2019 Abstract This study aimed to compare the effects of 3-dimension Schroth exercises and Kinesio taping (KT) on several variables in children with idiopathic scoliosis. Female volunteers aged 10 - 18 years with an angle trunk rotation > 7 degrees participated in the study. The 16 volunteers were divided into 2 groups: ‘Three-dimension Schroth exercises’ (Con) and ‘Kinesio tape with Schroth exercises’ (KT). The training program comprised 2 sessions per week with 2 h per session for 6 consecutive weeks. Significant increases of maximal inspiratory pressure (Con; p = 0.046), maximal expiratory pressure (Con; p = 0.046, KT; p = 0.047), and back muscle endurance (Con; p = 0.028, KT; p = 0.028) were recorded. Significant decreases of angle trunk rotation at the thoracic level (Con; p = 0.046, KT; p = 0.017) and the lumbar level (Con; p = 0.042, KT; p = 0.041) were recorded. In conclusion, 3-dimension Schroth exercises and KT with Schroth exercises can increase maximal expiratory pressure, back muscle endurance, and angle of trunk rotation at the thoracic and the lumbar level. Keywords: Three-dimension Schroth exercises, Kinesio tape, idiopathic scoliosis, angle of trunk rotation, inspiratory and expiratory muscle strength Introduction Idiopathic scoliosis (IS) is a disorder in which the spine shows an abnormal lateral curvature. IS occurs in 3-D; the spine is bent sideways in conjunction with its rotation, causing an altered curve of the scapula [1,2]. Scoliosis leads to deformities of the thoracic cage, weakness of the respiratory muscles, and limited mobility of the spine. In addition, there may be some pain involved [3-7]. A study by Inal-Ince et al. [8] found that the maximal inspiratory pressure, maximum inspiratory pressure (MIP) and maximal expiratory pressure, and maximal expiratory pressure (MEP) in patients with scoliosis that is caused by the nervous system is less than healthy. Furthermore, Martinez-Llorens et al. [9] reported that MIP and MEP in a group of IS patients were not normal. Schiller et al. [10] suggested that people with scoliosis should be exercising to be able to move better. Šarčević et al. [11] studied the strength of the muscle groups used in the posture of children with scoliosis aged 10 - 16 years. The authors found that the quadratus lumborum and gluteus medius muscles Walailak J Sci & Tech 2019; 16(12): 965-973. Schroth Exercises and Kinesio Taping Roongtip DUANGKEAW et al. http://wjst.wu.ac.th on the convex side of the spinal curvature were weaker than those on the concave side of the spine. The erector spine lumbalis and multifidus muscles of the concave side of the spine were weaker when compared with the convex side. In the thoracic region, the middle trapezius, lower trapezius, and serratus anterior muscles on the convex side were weak compared to the concave side. In addition, the rhomboid muscles on the concave side were weak compared to muscles on the convex side. If childhood scoliosis is left untreated, it will continue to cause problems in later life. Examples are low back pain disability, complications in the cardiopulmonary system and, associated with the limited body functionality, a low self-esteem [4,12-16]. The goal of the treatment of scoliosis with a conservative approach is to prevent curve progression throughout pubertal growth. This will reduce or even avoid development of respiratory cardiopulmonary problems and back pain caused by scoliosis. Treatment of scoliosis with specific exercises is a popular way to correct spine curvature. The 3-dimension Schroth exercises are a popular and widely known example of such exercises. Several studies demonstrated that exercise improved spinal conditions from 12 - 100 % [15,17-20]. The Cobb angle of 50 children (average age: 14.1 years) with scoliosis decreased from 26.18 to 17.88 after exercises for 6 weeks, 2 h per day, 5 days a week [17]. Afterwards the patients received a program to continue to work at home for 90 min a day. In another study, 43 children (average age: 12 years) with scoliosis and an average Cobb angle of 19.58 degrees underwent an exercise program [18]. The exercises continued for a period of 3 months, 2 h per day, 2 days per week. The patients did not receive any home exercise program. The results of the study showed that the participants improved their Cobb angle up to 44.2 %. Furthermore, Schroth treatment demonstrated a positive effect on back muscle strength and endurance [17,34]. In an RCT study, Schreiber et al. [34] revealed that Schroth treatment combined with the standard of care improved back muscle endurance in children with AIS after a 6- month training period. In addition, Otman et al. [17] reported Schroth treatment increased back muscle strength after 6 weeks, 6 months, and 1 year in all participants. To the best of the authors’ knowledge, there are only a limited number of studies of Schroth exercises that report on these results. Kinesio® taping method (KT) is linked to the tape that was developed by Dr. Kenzo Kase in 1979 and is still popular today. The tape is an elastic fabric and is designed to suit the properties of human skin. The flexibility of the tape is similar to skin, with an elasticity of 40 - 60 % of its resting length. It can also reduce the risk of skin irritation due to latex adhesive. The correct application of this tape is designed to fulfill 4 main objectives: (1) support muscle function, (2) adjust movement of the joints, (3) stimulate receptors in the skin, and (4) increase lymph flow under the skin [21-23]. A recent study found that KT is likely to stimulate muscle function. Hsu et al. [24] studied the effect of KT on the movement of the scapula and muscle function in baseball patients with shoulder impingement syndrome. They found that the use of KT with muscle facilitation techniques can activate the lower trapezius muscle during 60 - 30° abduction when compared with non-elastic tape. This finding is consistent with the study of Huang et al. [25] in which the authors found that the medial gastrocnemius muscle tends to work more in the KT group compared to the conventional elastic tape group. Also, Mirafzal et al. [26] presented results of high statistical significance showing that KT with exercise helps to shape a better posture in kyphotic adolescents. Chang et al. [27] studied the mistakes of grip strength in healthy athletes and found that KT has a lesser margin of error compared to placebo tape and no tape. This shows that KT can stimulate perception through skin and proprioceptive senses. The benefits of KT for the treatment of patients with idiopathic scoliosis have been demonstrated in additional researches. For example, KT was used with the objective to reduce pain, to activate muscles, and to stimulate awareness through receptors of the body [28]. Bac et al. [29] studied the effect of KT on children with scoliosis in comparison to non-elastic tape. The results showed a better angle of the spine and higher muscle tone in the KT group. The daily activities of the children improved and pain was reduced. In addition, these effects should persist for a longer time. Parents reported that KT motivated their children to exercise more. The expectation of the present study was to see if there is a superior effect on health if Schroth exercises are combined with KT. The result could then be used as a clinical guideline for the physiotherapeutic treatment of adolescent idiopathic scoliosis. Therefore, the objectives of this study were to study the effects of 3-dimension Schroth exercises and KT on general mobility of vertebrae, angle of 966 Walailak J Sci & Tech 2019; 16(12) Schroth Exercises and Kinesio Taping Roongtip DUANGKEAW et al. http://wjst.wu.ac.th trunk rotation, muscle strength and endurance of trunk, and inspiratory and expiratory muscle strength in adolescent idiopathic scoliosis. Materials and methods A total number of 16 female volunteers, aged 10 - 18 years and with an angle trunk rotation of more than 7 degrees [29], participated in the study. Inclusion conditions were: no history of spinal surgery, no history of allergies KT, and able to participate throughout the study. All included participants understood the purpose of this study and provided written informed consent prior to take part in this study. The protocol of this study was approved by the Ethical Review Sub-Committee Board for Human Research Involving Sciences, Thammasat University, No. 3. Volunteers were required to attend a total of 14 days. Data were collected on the first and the last day, before and after exercise. The recorded data included: general mobility of vertebrae, angle of trunk rotation, muscle strength and endurance of trunk, and inspiratory and expiratory muscle strength. Sixteen volunteers were randomly assigned into 2 groups ‘Three-dimension Schroth exercises’ (Con) or group ‘Kinesio tape with Schroth exercises’ (KT). Training sessions were scheduled for 2 days per week, 2 h per day for 6 consecutive weeks (total twelve days).
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